ABSTRACT
Background: Childhood obesity is a major concern in the US. Children from low income and minority families are at a particularly high risk. Quarantine and remote learning during COVID-19 pandemic may have exacerbated unhealthy behaviors and worsened obesity in children. The goal of this study was to determine whether the pandemic affected prevalence of obesity in high-risk children. Methods: BMI of 11-21y old adolescents seen for well-child visits in a large practice in Brooklyn, NY pre-pandemic (Oct 1, 2019-Mar 15, 2020) was compared to BMI during the pandemic (Mar 16, 2020-Feb 28, 2021). BMI was stratified into underweight (UNWT), normal (NL), overweight (OVWT), and obese (OB) as per CDC definitions. OB was stratified into class I (95-120%), II (121-140%) and III (>140%). Because BMI categories were not normally distributed, Kruskal-Wallis test was used to evaluate differences between groups. Results: Of 244 patients, 55.3% were female;61.1% 10-15y;54.5% had Medicaid;82% self reported as Black. Pre-pandemic, 3.7% were UNWT, 54.1% NL, 15.6% OVWT, and 26.7% OB: 15.6% in Class I, 7.0% in Class II, 2.9% in Class III, and 1.2% > Class III. Intra-pandemic, 17.8% shifted into the next higher BMI category. This happened for only 6.8% with NL BMI, but increasingly worsened for obese children (p < 0.001): 28.9% of OWVT, 28.9% of Class I, 41.2% of Class II, and 57.0% of Class III reached a BMI >160% of 95th percentile. There were no observed differences between groups related to demographics. Conclusions: This pilot study shows that pre-pandemic obese children are at very high risk of worsening obesity while normal weight children are protected. Future research needs to focus on understanding specific differences in eating and sedentary behavior that affects weight gain.